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Psychology Post-Doctoral Fellowship Program

The Psychology Post-Doctoral Fellowship program further develops and strengthens future clinicians' ability to assess and treat a wide variety of mental health concerns within the medical population.

This is a full-time, one-year fellowship program. Fellows will be expected to see an average of 20 direct patient care hours per week. Fellowship start date is anticipated to be September 9, 2019, but may be somewhat flexible based on the fellows chosen for these positions. The Pediatric Psychology Fellow and Adult Health and Rehabilitation Psychology Fellow will begin and end together.

Psychology Fellowship tracks

Track 1: Pediatric Psychology

The Pediatric Psychology Post-Doctoral Fellow will gain clinical experience under the supervision of Licensed Clinical Psychologists working across the hospital setting. The Pediatric Psychology Fellow will be offered opportunities to gain additional experience providing outpatient therapy; outpatient IQ/Achievement and ADHD testing services; inpatient consultation and liaison; working on multidisciplinary treatment teams; conducting crisis evaluation; and group therapy services. Services provided are short-term and evidenced-based. There is also potential for research collaboration and teaching opportunities. The Fellow will also have regularly scheduled supervision and didactic seminars. Opportunity to attend hospital wide Grand Rounds and Continuing Education conferences will also be available. Career development opportunities including licensure support will also be provided.

The Fellow will be physically located on Gundersen's main campus in La Crosse, Wis. The Fellow will have an office located in Outpatient Behavioral Health, in which they will see outpatient and testing patients. The Fellow will also interact with staff and patients on the Pediatrics Unit, Pediatrics Intensive Care Unit and Neonatal Intensive Care Unit through the consultation and liaison service. The Fellow will be included in multidisciplinary teams in the Pediatric Specialties and Pediatric Neurology departments, including Pediatric Allergy; Pediatric Gastroenterology; Pediatric Endocrinology; Pediatric Cardiology; Pediatric Hematology/Oncology; Pediatric Comprehensive Weight Management; and Pediatric Neurology. Formal participation in Cystic Fibrosis clinic and Pediatric Headache Clinic opportunities will also be available. The Fellow will regularly collaborate with the system's Pediatricians, who represent a significant referral source.

Fellowship goals and objectives

Vision: To train excellent early career pediatric psychologists.

Mission: To train fellows who will graduate from their fellowship experience with the clinical and professional background necessary to be highly competitive for the position of their choosing.

Aims of Fellowship:

  1. Function independently as a psychologist in a medical center and/or outpatient practice setting, providing evidence-based psychological assessment and treatment to children with a variety of medical and psychological conditions
  2. Complete supervised training requirements necessary to obtain state licensure to practice psychology (the fellowship meets licensure requirements for licensure in the state of Wisconsin)

Required Competencies of Fellowship

  1. Competence in clinical care that recognizes the mutuality and interaction of science and practice
  2. Competence in the interdisciplinary and biopsychosocial model of health care delivery
  3. Competence in clinical care that is effective, sensitive, and respectful for persons of diverse backgrounds
  4. Competence in ethical and professional issues

Competency Learning Elements

Adapted from: Palermo, Janicke, McQuaid, Mullins, Robins & Wu, 2014; Piazza-Waggoner, Karazsia, Hommel & Modi, 2015

Competency 1
Competence in clinical care that recognizes the mutuality and interaction of science and practice

  • Learning Elements
    • The fellow promptly and competently completes diagnostic assessment in an accurate and timely manner while also prioritizing rapport development with the family/patient.
    • The fellow is able to systematically and efficaciously conceptualize and formulate goals about how to treat a wide range of psychological conditions affecting children, adolescents, and their families.
    • The fellow autonomously writes well-organized psychological documentation on children and youth seen in a medical setting, which clearly answers the referral concerns and provides the multidisciplinary team with appropriate diagnostic input and directions/recommendations for interventions.
    • The fellow implements interventions that are well-timed, effective, and consistent with empirically supported treatments.
    • The fellow completes consultations that are well-timed, effective consistent with empirically supported treatment and addressed the medical team needs.

Competency 2
Competence in the interdisciplinary and biopsychosocial model of health care delivery

  • Learning Elements
    • The fellow is able to independently interact with professionals and colleagues from other disciplines on teams and can integrate their information with the information provided by other professionals.
    • The fellow is knowledgeable about the interaction between biological and psychosocial variables influencing the clinical presentation and is able to accurately assess psychosocial aspects of clinical cases.

Competency 3
Competence in clinical care that is effective, sensitive and respectful for persons of diverse backgrounds

  • Learning Elements
    • The fellow is aware of the patient's worldview and how it impacts conceptualization of assessment and treatment with culturally diverse children, adolescents and their families.
    • The fellow is aware of his/her own biases and how these impact work with children, adolescents, and families from diverse backgrounds so as to provide culturally sensitive services.

Competency 4
Competence in ethical and professional issues

  • Learning Elements
    • The fellow demonstrates good knowledge of the following and is able to apply principles consistently, seeking consultation as appropriate.
      • Ethical Principles of Psychologist and Code of Conduct established by the American Psychological Association
      • Wisconsin Psychology Law
    • The fellow demonstrates use of positive coping strategies to manage personal and professional stressors to maintain high standards of professional functioning.
    • The fellow effectively prioritizes and accomplishes tasks in a timely fashion.
    • The fellow demonstrates professionalism in relationships with colleagues and staff and is adherent to Department policies, including clinical and administrative responsibilities.

Track 2: Adult Health and Rehabilitation Psychology

The Adult Health Psychology Fellow will work under the supervision of a licensed, board certified Clinical Health Psychologist primarily in Gundersen Behavioral Medicine's outpatient clinic. The Adult Health Psychology Fellow will have opportunities to conduct psychological evaluations, personality testing, crisis evaluations and individual and group therapy services, with many referrals coming from specialty medical clinics. Collaboration with multi-disciplinary medical teams is also expected. The Fellow will have opportunities for evaluation and treatment of patients in the following areas: weight management (bariatric surgery, medical/behavioral weight management); eating disorders; pain management; audiology/tinnitus; insomnia; and general mental health conditions that may be occurring in the context of adjusting to or experiencing chronic medical condition.

The Rehabilitation Psychology Rotation includes neuropsychological and psychological evaluation, treatment and consultation within Gundersen Physical Medicine and Rehabilitation in both inpatient and outpatient clinic settings. The Inpatient Rehabilitation Unit is currently a 16-bed, acute rehabilitation unit servicing the full spectrum of rehabilitation populations across the adult lifespan. The primary population served consists of individuals with stroke, followed closely by those with traumatic brain injury (TBI). The remainder of the patient populations served includes those with debility, chronic and significant medical illnesses that compromise physical and/or cognitive functioning, limb amputation and spinal cord injury.

The rehabilitation team consists of two physiatrists, multiple mid-level staff (physician assistants and nurse practitioners); rehabilitation nursing staff; a rehabilitation psychologist; speech therapists; occupational therapists; physical therapists; recreation therapists; social workers; nutritionists; and a chaplain. The Fellow will have ample opportunity to work closely with these providers as part of a strong, collegial and well-integrated interdisciplinary team. The Fellow will also have the opportunity to be a part of the Spinal Cord Injury Service Line, where the Rehabilitation Psychology Service follows all patients with traumatic spinal cord injury across the continuum of care, often intervening in the Critical Care Unit/ICU as well as the Neuroscience Unit prior to admission to the Rehabilitation Unit. There will also be opportunities for the Fellow to see clinic patients for routine follow-up from acute rehabilitation and for outpatient neuropsychological evaluation.

Fellowship goals and objectives

Vision: To develop competent early-career clinical psychologists by providing advanced training in health and rehabilitation psychology, which includes the provision of psychological assessment and intervention to medical populations, as well as consultation to interdisciplinary medical teams.

Mission: To train fellows who will graduate from their fellowship experience with the clinical and professional foundation necessary to practice high quality, evidence-based care and attain the psychologist position of their choosing.

Aims of Fellowship:

  1. Function independently as a psychologist in a medical center and/or outpatient practice setting, providing evidence-based psychological assessment and treatment to adults across the lifespan who have various medical and psychological conditions.
  2. Complete supervised training requirements necessary to obtain state licensure to practice psychology (the fellowship meets licensure requirements for licensure in the state of Wisconsin).

Required Competencies

Competency Learning Elements

Competency 1
Integration of Science and Practice

Description: The integration of scientific literature and evidence-based theory and research into clinical practice. This includes the fellow's ability to utilize knowledge of the existing literature in approaching assessment, conceptualization and intervention.

  • Learning Elements
    • Fellow is able to critically evaluate and apply relevant literature to inform the approach to assessment and intervention with patients and families.
    • Fellow utilizes relevant literature to conceptualize assessment findings and formulate an approach to intervention or management that is tailored to the unique needs of the patient.
    • Fellow provides consultation to interdisciplinary care teams that is based on relevant scientific findings related to the patient presenting concerns.
    • Fellow is able to demonstrate knowledge of psychometric properties, strengths, and limitations of psychological and neuropsychological measures administered as part of a patient's care, and is able to demonstrate sound interpretation of such measures in light of a patient's presenting concerns and functional capabilities.

Competency 2
Individual and Cultural Diversity

Description: The recognition and understanding of how one's own cultural background impacts clinical practice, while also striving for multicultural competence across various aspects of cultural diversity, including disability.

  • Learning Elements
    • Fellow demonstrates awareness of how his or her own cultural background and worldview influences interactions with patients.
    • Fellow demonstrates awareness of how a patient's cultural background and worldview influence his or her beliefs about health and wellness as well as interaction with the healthcare system
    • The fellow is knowledgeable about the interaction between biological and psychosocial variables influencing the clinical presentation and is able to accurately assess psychosocial aspects of clinical cases.
    • Fellow demonstrates sound interpretation of psychological and neuropsychological measures in accordance with a patient's cultural background.
    • Fellow demonstrates awareness and knowledge of disability and age as other facets of diversity and is able to address these factors in his or her interactions with patients.

Competency 3
Ethical and Legal Foundations

Description: The awareness of standards of professional conduct, ethics and law, as well as how these impact clinical practice of psychologists within a medical setting.

  • Learning Elements
    • Fellow demonstrates knowledge of applicable laws and ethical standards (APA Ethics Code) pertaining to the broader practice of psychology as well as the specific practice of psychology in the medical setting.
    • Fellow demonstrates knowledge of HIPAA and institutional policies protecting the privacy and confidentiality of patients.
    • Fellow demonstrates knowledge of Wisconsin Statutes governing the practice of psychology.

Competency 4
Assessment

Description: The appropriate selection, administration, modification (where indicated) and interpretation of standardized tests, behavioral observations, and/or clinical interviews based on the needs of the patient and upon which recommendations are made and communicated to optimize patient outcomes.

  • Learning Elements
    • Fellow is able to assess adjustment to illness/disability in patients.
    • Fellow is able to assess adjustment to illness/disability in family members.
    • Fellow is able to assess the extent and nature of disability and preserved abilities/strengths.
    • Fellow is able to evaluate educational and vocational capacities where indicated.
    • Fellow is able to assess mood and personality functioning to inform interventions.
    • Fellow is able to evaluate cognitive functioning.
    • Fellow is able to evaluate decision-making capacity.
    • Fellow is able to assess for substance use disorders.
    • Fellow is able to assess pain and associated psychological factors.
    • Fellow is able to evaluate psychological strengths and risk factors of individuals seeking surgery and make appropriate recommendations to interdisciplinary teams regarding candidacy for surgery.
    • Fellow is able to assess social and behavioral functioning in patients with neurologic conditions.
    • Fellow is able to assess concerns related to sexual functioning in individuals with disabilities.

Competency 5
Intervention

Description: The selection of appropriate treatment modalities for the needs of the patient, and conducts said interventions with skill, sensitivity, and use of a relevant knowledge base so as to optimize patient outcomes.

  • Learning Elements
    • Fellow can appropriately select and utilize empirically-supported interventions across a wide range of presenting psychological concerns including depression, anxiety, mood disorders, and acute and chronic stress.
    • Fellow can utilize empirically-supported behavioral interventions for medical conditions including pain, obesity, insomnia, cancer tinnitus and other acute or chronic illnesses.
    • Fellow can utilize empirically-supported interventions as related to adjustment to disability/illness and prevention of chronic illness.
    • Fellow can utilize empirically-supported family/couples therapeutic interventions as related to disability/illness and the prevention of chronic illness.
    • Fellow is able to guide and implement behavioral management interventions for individuals with neurologic/cognitive impairments.
    • Fellow is able to utilize assessment of concerns related to sexual functioning in individuals with disabilities to guide intervention.

Competency 6
Consultation

Description: The effective consultation with other professionals appropriate to the needs of the patient, in ways that will promote efficiency of care and transdisciplinary collaboration.

  • Learning Elements
    • Fellow can consult with interdisciplinary team members to improve behavioral functioning of patients in order to optimize participation in rehabilitation efforts.
    • Fellow can provide consultation to interdisciplinary teams regarding psychological and behavioral interventions for shared patients.
    • Fellow can provide consultation regarding cognitive functioning and modification of rehabilitation efforts in light of this.
    • Fellow can engage the interdisciplinary team in vocational/educational planning for individuals with neurologic illness.
    • Fellow can consult with members of the interdisciplinary team regarding findings on assessment of personality and mood as they impact participation in care and adherence to recommendations.

Competency 7
Professional Values, Attitudes and Behaviors

Description:

The sensitivity to the welfare, rights, and dignity of others as a priority in clinical practice. This also involves the capacity to empathetically relate to clients/patients and others, including members of the interdisciplinary care teams, in ways that enhance the effectiveness of services provided.

  • Learning Elements
    • Fellow respects and attends to the welfare of patients, their rights, and dignity across clinical work.
    • Fellow demonstrates the ability to assess a patient's capacity across multiple domains, and advocates for patients' autonomy in accordance with their capabilities.
    • Fellow demonstrates good boundaries with patients and staff.
    • Fellow demonstrates the ability to collaborate effectively with other disciplines to the benefit of the patient.
    • Fellow is receptive to feedback and suggestions form supervisors and other professional colleagues.


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